Raheel Ahmad, Muhammad Salman Shafique, Shahbaz Zafar, Saqib Mehmood, Sajid Mehmood, Usman Qureshi, Jahangir Sarwar Khan.
INTESTINAL TUBERCULOSIS; Pattern of presentation and surgical management.
Professional Med J Jan ;23(11):1334-9.

Tuberculosis is one of the leading causes of morbidity and mortality, responsible for annual 7–10 million new cases and 6 per cent of deaths in developing countries. It can involve any part of abdomen but most common is intestinal tract in which it can present with wide variety of symptoms. Early diagnosis and appropriate management is challenging for clinicians. Objectives: To determine the modes of presentation of abdominal tuberculosis and effectiveness of surgical procedures in our setup. Study Design: A retrospective study. Setting: Surgical unit-I of Holy Family Hospital, Rawalpindi. Period: January 2014 to December 2014. Materials and Methods: 50 patients with abdominal tuberculosis were included in the study. Histopathology confirmed the diagnosis of abdominal tuberculosis. Age, gender, mode of presentation, evidence of co-existing tuberculosis, family history, drug history of antituberculous treatment, laboratory and radiological investigations, treatment modalities and duration of hospital stay were recorded. Results: There were 28 female (56%) and 22 male (44%) patients with a mean age of 29± 10.23 years. 56% patients presented with subacute intestinal obstruction, 16% with acute intestinal obstruction and 14% with peritonitis. All 50 patients underwent laparotomy. Ileocecal mass with perforation (40%) was seen as the most common per-operative finding. Limited right hemicolectomy with ileocolostomy (44%) was performed in most of the cases. Mean length of hospital stay was 10 ± 4.67 days. Conclusion: Abdominal tuberculosis is a common cause of acute abdomen especially intestinal obstruction in our setup, with a variable mode of presentation. Early diagnosis with appropriate surgical management and chemotherapy can prevent significant morbidity and mortality.

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